【摘要】 目的 :了解长期服用哌甲酯对注意力缺陷多动障碍(ADHD)患者身高和体重发育的影响。方法 :收集2009年6月至2016年12月复旦大学附属儿科医院心理科收治的ADHD患儿222例,均接受盐酸哌甲酯缓释剂(osmotic release oral system-methylphenidate,OROS-MPH)治疗> 6个月,其中仍在服药者135例。根据自编的《ADHD儿童药物使用情况调查表》和SNAP-Ⅳ对患儿进行随访,并记录其身高和体重。结果 :在135例仍在服用OROS-MPH的患儿中,身高低于P25的有66例,占48.89%,体重低于P25的有51例,占37.78%,均与药物剂量呈正相关。在135例中,54.8%的患儿出现食欲不振,与体重呈负相关;34.10%出现难以入睡,与身高呈负相关。在停止用药的患儿中,身高、体重低于P25的例数与用药时的剂量和疗程均无明显相关性。结论 :服用OROS-MPH> 6个月可以明显改善ADHD儿童的核心症状和学习功能,但可能会影响其身高和体重的增长,且剂量越大,影响越大。用药期间出现的入睡困难和食欲不振影响患儿当时身高体重的增长,但停药6个月后这些不良反应将会逐渐消失。更多还原

【Abstract】 Objective: To determine the influence of long term use of methylphenidate on height and weight development of children with attention deficit hyperactivity disorder(ADHD). Methods: A total of 222 cases of children with ADHD who were admitted to the Department of Psychology of Children’s Hospital affiliated to Fudan University from June 2009 to December 2016 were collected and all received osmotic release oral system-methylphenidate(OROS-MPH) treatment for more than 6 Months, of whom 135 were still taking medication. According to the self-made "ADHD children drug use questionnaire" and SNAP-Ⅳ, the children were followed up, and their height and weight were recorded. Results: Among the 135 children still taking OROS-MPH, 66 were lower than P25, accounting for 48.89%, and 51 were lower than P25, accounting for 37.78%, all of whom were positively correlated with drug dose. In 135 cases, 54.8% of children suffered from loss of appetite, which was negatively correlated with body weight; 34.10% had difficulty falling asleep, which was negatively correlated with height. In the children who stopped taking the drug, the number of children, whose height and weight were lower than P25, had no significant correlation with the dose and course of treatment. Conclusion: Taking OROS-MPH for more than half a year can significantly improve the core symptoms and learning function of children with ADHD, but may also decelerate their growth of height and weight, and the greater the dose, the greater the impact. Difficulty falling asleep and poor appetite during medication treatment influence the growth of height and weight at that time, but these side effects will gradually disappear after half a year of drug withdrawal.更多还原